ESE Ed Eval Self Assessment Form_General



Primary Evaluator—Name/Title: FORMTEXT ?????Supervising Evaluator, if any—Name/Title/Role in evaluation: FORMTEXT ?????School(s): FORMTEXT ?????Part 1: Analysis of Student Learning, Growth, and AchievementUsing evidence such as results from available assessments, briefly summarize areas of strength and high-priority concerns for students under your responsibility for the upcoming school year. This analysis will inform the development of your student learning goal(s).603 CMR 35.06 (2)(a)1 FORMTEXT ?????Part 2: Assessment of Practice Against Performance StandardsCiting your district’s performance rubric, briefly summarize areas of strength and high-priority areas for growth. Areas may target specific Standards, Indicators, or elements, or span multiple Indicators or elements within or across Standards. This assessment will inform the development of your professional practice goal(s).603 CMR 35.06 (2)(a)2 FORMTEXT ?????Part 3: Goal-SettingBased on strengths and areas for growth identified in your self-assessment, identify a minimum of one student learning goal and one professional practice goal. Team goals must be considered per 603 CMR 35.06(3)(b). Attach pages as needed for additional goals or revisions made to proposed goals during the development of the Educator Plan. S.M.A.R.T.: S=Specific and Strategic; M=Measurable; A=Action Oriented;R=Rigorous, Realistic, and Results-Focused; T=Timed and TrackedCheck all that apply: FORMCHECKBOX Proposed Goals FORMCHECKBOX Final Goals Date: FORMTEXT ?????Student Learning S.M.A.R.T. GoalCheck whether goal is individual or team; write team name if applicable.Professional Practice S.M.A.R.T. GoalCheck whether goal is individual or team; write team name if applicable. FORMCHECKBOX Individual FORMCHECKBOX Team: FORMTEXT ????? FORMTEXT ????? FORMCHECKBOX Individual FORMCHECKBOX Team: FORMTEXT ????? FORMTEXT ????? Signature of Educator FORMTEXT ?????Date FORMTEXT ?????Signature of Evaluator* FORMTEXT ?????Date FORMTEXT ?????* The evaluator’s signature indicates that he or she has received a copy of the self-assessment form and the goal setting form with proposed goals. It does not denote approval of the goals. ................
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